11 July 2012 9:57 AM

We all need to plan for social care costs - but we still won't have the bill

Credit where it is due – Andrew Lansley has gone where no previous health secretary has ventured for 60 years in his Social Care White Paper being published today. It will say that Councils must provide low-interest loans to cover care-home fees from 2015, and that there should be a limit on how much any individual is expected to pay. The Paper will also recognise the contribution made by family carers, will announce more money for specialist housing as well as setting out how more people can be looked after in their own home rather than being forced into a nursing home.

It was Derek Wanless in his second report of nearly a decade ago who projected that between 2005 and 2025 there would be an increase in demand for elderly care of 54%, and this has been borne out by the tightening of Council criteria for providing social care to only those with substantial or critical needs. At the same time thousands of care home places have been lost due to a combination of lack of funding, EU regulation and a move to care-at-home, which in the case of some of my old patients left them lonely, isolated and with no option for company.

However campaigners won’t be happy. There remains a blank in the Paper where it should say what the limit is on how much will have to pay – what the cap will be on personal liability for social care costs. And this will remain a blank for probably another two years. The risks here are both that people will continue to think that they won’t have to pay for care and don’t save or plan for it, and that there will be a delay in people taking out insurance to cover their fixed liability. Another unsolved problem that Mr Lansley cannot afford to tolerate are the numbers of elderly who remain in hospital because there is no care home placement or care-in-the-community package available. This can only get worse if more resources are not found.

Fundamentally there is no way that we can get around the fact that we will all need to plan to pay for social care, and we need to accept that we should also plan to take responsibility for our elderly relatives while we are able. We have been spoilt by the welfare state and the tough times we are in are partly due to our profligacy. Wouldn’t it be better to get all the bad news out of the way, let us get on with accepting we have to take more personal responsibility for social care and start planning for it?

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JULIA MANNING

Julia studied visual science at City University and became a member of the College of Optometrists in 1991. Her career has included being a visiting lecturer in at City University, visiting clinician at the Royal Free Hospital, working with Primary Care Trusts and a Director of the UK Institute of Optometry. She also specialised in diabetes and founded Julia Manning Eyecare, a practice for people with mental and physical disabilities. In 2006 she established 2020health.org, an independent Think Tank for Health and Technology. Research publications have covered public health, telehealth, workability, pricing of medicines, biotechology, NHS reform and fraud.